Kemi Osilesi, AGNP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AG10190130 Issued in CA

Practice address

1943 Seasons St
Simi Valley, CA 93065-0580

Phone

(310) 503-2515

NPI assigned

Nov 7, 2019

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• California Mobile Medical Group Inc

  • Family Medicine Physician
  • Glendale, CA
  • NPI 1588439061
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1447895073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2828 COCHRAN ST STE 492",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930652780",
            "telephone_number": "310-503-2515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1943 SEASONS ST",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930650580",
            "telephone_number": "310-503-2515"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3436 Deep Waters Ct",
            "address_purpose": "LOCATION",
            "city": "Simi Valley",
            "state": "CA",
            "postal_code": "930650587",
            "country_code": "US",
            "telephone_number": "310-503-2515",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OSILESI",
        "first_name": "KEMI",
        "name_prefix": "Mrs.",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CA",
            "license": "AG10190130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Viviane Liza Ordonez
• Jennifer Orellana, LVN
• Susan D Organ, P.T.
• Isabel Oropeza Perez
• Beatriz Susana Orvis, N.P.
• P Shahbazian DDS Corporation
• Pacific Cardiovascular Associates, Inc
• Pacific Health Care,Inc.
• Pacific Toxicology Management, Inc
• Pacwest Nursing Inc

• Gerontology Nurse Practitioner in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Gerontology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.